Journal of Education and Health Promotion

The effect of macroeconomic indicators on health‑care expenditure in Iran

Document Type : Original Article

Authors

. Mohsen Pakdaman
. Sara Geravandi 1
. Roohollah Askari
. Mohsen Askarishahi 2
. Hasan Reza Afzali

1 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract
INTRODUCTION: A sharp increase in expenditure is one of the challenges of the health system
in Iran. Every macroeconomic variable affects health, and if it is disregarded, it will lead to higher
macrobudgets. Physical and mental health as well as the use of health services change according
to the macroeconomic conditions and business cycles (boom and recession). The present study
aimed to determine the effect of macroeconomic indicators on health expenditure.
METHODS: This study was descriptive analytical. The required data related to macroeconomic
indicators and health expenditure in public and private sectors were collected during 1995–2014.
The data were analyzed using the time series models in econometrics, Vector Auto Regression,
and Granger causality technique.
RESULTS: The results of this study indicated that health expenditure has a positive bilateral
relationship with gross domestic production (GDP), gross national production, national income,
and national consumption. On the contrary, expenditure has a negative bilateral relationship with
liquidity rate and inflation rate. In addition, budget deficit has a negative unilateral relationship with
health expenditure while population rate has a positive unilateral relationship with health expenditure.
CONCLUSION: The results of this study indicated the increase of health expenditure in Iran that
GDP is the most critical determining factor of health expenditure. In general, the total expenditure in
the health sector in the world increases when the countries become richer. In line with the increase
of resources, innovative financing methods and efficiency improvement are required for providing
basic health services in low‑income countries.

Keywords

Health
health expenditure
macroeconomic indicators
1. World Health Organization. The World Health Report; Health
Systems: Improving Performance. Geneva: World Health
Organization; 2000. p. 1.
2. Ebadi Fardazar F, Rezapour A. Health Care Economics. Tehran:
Rahe Tandorosti; 2013. p. 252‑5.
3. Ahmdkya AA, Moradi N. Culture of health system performance
assessment framework. J Soc Secur 2005;7:33‑61.
4. Nasrollahpour Shirvani SD, Moudi S. Evidence‑Based
Policy‑Making in the Health System and its Achievements and
Challenges of Publishing in Iran. Babol: Babol University of
Medical Sciences and Health Services; 2013. p. 22.
5. Shahri S, Tabibi SJ, Nasiripour AA, Ghaffari F. Effect functions on
goals of health system in Iran. J Payavard Salamat 2016;11:247‑58.
6. Catalano R. Health costs of economic expansion: The case
of manufacturing accident injuries. Am J Public Health
1979;69:789‑94.
7. Ruhm C. Good times make you sick. J Health Econ
2003;22:637‑58.
8. Quadrado L, Lopez‑Bazo E. Macroeconomic Variables & Regional
Welfare: An Application to the Spanish Regions, Paper Presented
to the 36th European Congress of European Regional Science
Association, Zurich, Switzerland; 1996.
9. AlaviRad A, Ghafoori M, Ghorashi N. Compare the effect of health
on Iranian economic growth and vision basin countries. Toloo E
Behdasht 2014;13:136‑46.
10. Burns JR. Debt Dependency, Debt Relief, and Macroeconomic
Policies. Ph.d Thesis in Sociology. Texas A & M University; 2004.
11. Rajabpour H, Zare H. Comparative study of general health
insurance system in selected countries and providing a proper
plane. J Soc Secur 2008;8:79‑104.
12. Davari M. The economic challenges of the Iranian health system.
Health Econ 2012;8:915‑7.
13. Davari M, Haycox A, Walley T. Issues related to health care
delivery system in Iran; Past experiences, current challenges and
future strategies. Iran J Public Health 2012;41:1‑9.
14. Folland S, Goodman AC, Stano M. The Economics of Health and
Health Care. New York: Pearson Prentice Hall; 2007. p. 148‑50.
15. Davari M, Haycox A, Walley T. The Iranian health insurance
system; past experiences, present challenges and future strategies.
Iran J Public Health 2012;41:1‑9.
16. Ahmadi AM, Hasan MG, Emadi SJ. Correlation between
macroeconomic variables and health in Iran. Soc Welfare J
2009;10:7‑32.
17. Fattahi, M. The role of urbanization rate in the relationship
between air pollution and health expenditures: a dynamic panel
data approach. Int Lett Soc Humanist Sci 2015;53: 68‑72.
18. Mehrara M, Fazaeli A. Relationship between health expenditures
and economic growth in MENA countries. Faslname Modiraite
Salamat 2009;12:49-59.
19. Ahmadian L, Nejad SS, Khajouei R. “Evaluation methods used
on health information systems (HISs) in Iran and the effects of
HISs on Iranian healthcare: A systematic review.” International
Journal of Medical Informatics (2007);84:444‑453.
20. Acemoglu D, Finkestein A, Notowidigdo M. Incom and health
spending: Evidence from oil price shocks. Rev Econ Stat.
2013;95:1079‑95.
21. Sen B, Rout HS. Determints of houswhold health expenditure:
Case of urban Orissa. Utkal Econ Paper 2007;13:17‑23.
22. Abbas F, Hiemenz U. Determinants of public health expenditures
in Pakistan. ZEF Discuss Papers Dev Policy 2011;158:30‑48.
23. Grossman M. On the concept of health capital and the demand
for health. J Polit Econ 1972;80:223‑55.
24. Shahabadi A, Ghorbani Golparvar M. Effect of incidence on health
expenditure in Iran. Econ Model Sched 1395;10:133‑57.
25. Mehrolhassani MH, Najafi B, Dehnavie R. Total health
expenditures and pay percentage from pockets in Iran’s provinces,
2008‑2014. Iran J Epidemiol 2016;12:1‑12.
Journal of Education and Health Promotion
Volume 9, Issue 6
June 2019
Pages 1-6

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us